APPLICATION FORM

Application and/or Registration Information

(For office use only) Person Number Course Code

For which course/certificate programme are you enrolling?

Course Date

When do you wish to commence study? Year Month Day

Have you applied to and/or If yes, please provide

been registered at Wits University before? Yes No your student number

Are you currently or previously been a staff If yes, please provide

Yes No your staff number
member?

Personal details
Surname/Last name First name/s

Middle/Other name Marital status single married divorced widow/er

(the name your friends and family use or the name you prefer to be called)

Title Mr Miss Ms Mrs Other Date of birth

Day Month Year

Gender Male Female

Citizenship Details
South African citizen? Yes No South African ID no.

(Submit a certified copy of South African Identity Document)

If No, are you a South African Permanent resident? Yes No

If Yes, Permit number and date obtained:
Submit certified copies of Permanent Residence Certificate and Permanent Residence Visa)

If not a South African resident, please state nationality

Passport no.

Date of issue of passport Expiry date

Day Month Year Day Month Year

Classification of VISA Expiry date

Day Month Year

*PLEASE NOTE: Students need to have a certified copy of their Passport and Visa when registering for a short course.
General Background

Population Group (required by Government for statistical purposes)

African Asian Coloured Indian White Other

Home language Religion

Disability / Special Needs

Contact details
Home Tel Fax Cell

Email

Work Tel Fax

Email

Residential address

Postal code

Postal address

Postal code

Next- of-kin details

Surname/Last name First name/s

Middle/Other name Marital status single married divorced widow/er

(the name your friends and family use or the name you prefer to be called)

Mr Miss Ms Mrs Other Gender Male Female

Title

South African ID no.

Relationship to applicant

Home Tel Fax Cell

Email

Residential Address

Postal Code

How did you hear about Wits Language School?

Newspaper Family/Friend Internet Magazine Social media Other – please specify

Please specify Please specify

which one which one

Promotion code Referred by

Details of person/company responsible for payment
Company Name

Name and Surname

Position

Fax Cell
Contact details: Tel

Email

Contact person

Physical address

Postal code

Postal address

Postal code

Payment details
Once you have been accepted to register for the course, you will receive further details and instructions regarding
the required fee payment on an official Tax Invoice.

Proof of payment must be emailed 2 weeks prior to commencement date of the course to wls@wits.ac.za.

Should a direct deposit and/or electronic transfer be made, please provide proof of payment by quoting
"Your invoice number" as a reference.

Declaration
I ………………………………………….................................................................hereby certify that the information
provided above is accurate and complete in all respects and agree to be bound by it.

I agree to abide by all policies, rules, regulations and procedures of Wits University.

I confirm that I, the student and/or sponsor, have provided accurate information and comply with being a student
at Wits Language School.

I confirm that, I have read and understood the terms and conditions and the legal declaration of indemnity
and undertaking.

I hereby give consent to the processing of my personal information for the purposes pertaining to my application
and/or registration at Wits Language School.

.................................................. ..................................................
Signature of student Signature of the sponsor

...................................................... ..................................................
Date Date
Terms & conditions
Fees
I. All students are required to pay the full fee for the level/course for which
they are enrolling, at least two weeks prior to the start of the course.
II. Private tuition is offered for individuals and small groups of up to 8
students.
III. A fee per person per hour is charged for students who attend catch up
lessons.
IV. WLS reserves the right to withhold examination results until the
outstanding accounts are settled in full.
V. The student is solely responsible for his/her account.
VI. The following methods of payment are accepted: credit/debit card, bank
cheque, direct deposits and electronic payments.
VII. Should a direct deposit and/or electronic transfer be made, please
provide proof of payment as per instruction on the Tax Invoice.
Cancellations and refunds
I. A student may not cancel his/her enrolment in a course and will not be
exonerated from liability for the course tuition fee and course material
fee(s).
II. No refunds are granted to students who fail to attend the course for
which they have registered and paid.
III. Refunds will only be granted under the following conditions:
• If a student cancels thirty (30) days or
more before the course starts, 90% of
the course fee will be refunded
• If a student cancels within thirty (30) days before the course
starts, 50% of the course fee will be refunded
• No refunds will be granted after the start of the course
• Foreign students need to submit a letter from their embassy
confirming the status of their visa application for us to proceed
with their refund.
IV. A student must complete the course for which he/she enrolled within
one year of registration.
V. WLS reserves the right to postpone or cancel a course due to lack of
demand. In the event of cancellation, as opposed to postponement, all
fees paid may be refunded.
Transfer from one course to another
I. A student who wishes to transfer from one course to another must apply
in writing for permission to do so from Wits Language School.
II. WLS reserves the right to accept/decline the student’s application for
the transfer of his/her registration to another course.
III. The transfer can only occur within the calender year of the registration,
failing which the course fee is forfeited.
IV. A student will be liable for additional payment for the course material for
the course to which he/she is transferring, where applicable.
V. A student will be liable for the cost of the course material of the original
course/registration.
Deferral of courses
I. A student who wishes to defer his/her enrolment to a commencement
date later in the year must apply in writing for permission to do so from
Wits Language School.
II. Such application has to be forwarded to WLS within fourteen days
prior to the commencement of the course.
III. The deferred course must be done within the calender year of the
date of registration.
IV. An additional charge may be levied for deferrals at the discretion of WLS.
The following material must accompany the application
I. A certified copy of the front page of student’s ID book or both sides of
the ID card (if South African citizen), or the passport page with the
photo and personal information (if non-South African).
II. A certified copy of the front page of ID book or both sides of the ID card
of person(s) responsible for payment of the account, or the passport
page with the photo and personal information (if non-South
African).
III. A certified copy of the student’s study permit and relevant page of
passport (if non-South African).
IV. Proof of payment with the correct reference number.
The enrollment will only be considered once the registration form is
completed, the correct documentation attached, and the required fee is
furnished to WLS.
Legal declaration of indemnity and undertaking
I, the applicant, parent/guardian/next-of-kin/sponsor
of the applicant:
I. Acknowledge that the University does not accept responsibility for
damage or loss in respect of property of the applicant or in respect of
property brought onto University premises by the applicant.
II. Do hereby indemnify the University in respect of any damage caused by
the applicant to University property or to the property of third parties,
whether on or off the University premises, as a result of the
applicant’s actions either whilst on the University premises or whilst
engaged in any activity related to the University.
III. Undertake, during the period for which I am a registered student, to be
bound by the rules and regulations of the University, including the rules
and regulations of any University residence, club or society to which I
may be admitted or become a member, and by any requirements or
conditions imposed by the University.
IV. Certify that the information provided in this form and all supporting
documentation is accurate.
V. Declare that I have furnished the University with all the information
required to make an informed decision about my admission.
VI. Undertake to pay unconditionally all fees, charges and equipment
surcharges payable to the University as they fall due for payment, for
any period for which I am or may become a registered student or the
applicant is or may become a registered student of the University.
Terms of enrolment
I. The non-attendance of classes will not result in a reduction of the
student fees, nor will it absolve the other to this registration form
from full liability for the payment of fees.
II. The student cannot cancel this contract without written consent from
the University.
III. This registration or contract is not transferable to another person.
IV. The University reserves the right to change timetables, course
commencement dates, postpone or cancel tuition in any course
initially advertised and offered, on the basis of insufficient demand
or any other reasonable ground.
V. The student agrees to be bound by rules of due performance. The
University reserves the right to exclude the student from an
examination and to withhold a student’s examination results if his/her
due performance requirements have not been met, without in any
way detracting from the right of the University to recover fees
payable.
VI. Fees payable to WLS comprise tuition, registration and course
material fees. It is the student’s responsibility to cover the cost of
transport, specialized consumables used during the course,
including but not restricted to specialised stationery, stock or any
other materials.
VII. WLS chooses as its domicilium citandi et executandi (the residential
address) for all purposes arising here:
Wits Language School
University of the Witwatersrand, East Campus
PDH, Gate 6, 92 Empire Road
Braamfontein, Johannesburg.
VIII. Certificates of Competence and Certificates of Attendance are offered by
WLS. Please consult WLS for details per course.
IX. A Certificate of attendance requires at least 80% attendance by the
student, and a certificate of competence requires the student to pass
formative and summative assessments.
For any queries please contact the Wits Language
School: Tel.: 011 717 4208 Email: wls@wits.ac.za
Thank you for choosing Wits Language School.